Objective

Most women live to experience menopause and will spend 4–8 years transitioning from fertile age to full menstrual stop. Biologically, reproductive ageing is a continuous process, but by convention, it is defined categorically as pre-, peri- and postmenopause; categories that are sometimes supported by measurements of sex hormones in blood samples. We aimed to develop and validate a new tool, a reproductive ageing score (RAS), that could give a simple and yet precise description of the status of reproductive ageing, without hormone measurements, to be used by health professionals and researchers.

Methods

Questionnaire data on age, menstrual regularity and menstrual frequency was provided by the large multicentre population-based RHINE cohort. A continuous reproductive ageing score was developed from these variables, using techniques of fuzzy mathematics, to generate a decimal number ranging from 0.00 (nonmenopausal) to 1.00 (postmenopausal). The RAS was then validated with sex hormone measurements (follicle stimulating hormone and 17β-estradiol) and interview-data provided by the large population-based ECRHS cohort, using receiver-operating characteristics (ROC).

Results

The RAS, developed from questionnaire data of the RHINE cohort, defined with high precision and accuracy the menopausal status as confirmed by interview and hormone data in the ECRHS cohort. The area under the ROC curve was 0.91 (95% Confidence interval (CI): 0.90–0.93) to distinguish nonmenopausal women from peri- and postmenopausal women, and 0.85 (95% CI: 0.83–0.88) to distinguish postmenopausal women from nonmenopausal and perimenopausal women.

Conclusions

The RAS provides a useful and valid tool for describing the status of reproductive ageing accurately, on a continuous scale from 0.00 to 1.00, based on simple questions and without requiring blood sampling. The score allows for a more precise differentiation than the conventional categorisation in pre-, peri- and postmenopause. This is useful for epidemiological research and clinical trials.

中文翻译：

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简单而准确地描述生殖衰老的状况：基于三个问题并用激素水平验证的生殖衰老评分。

客观的

大多数女性都会经历更年期，从生育年龄过渡到完全停经需要 4 至 8 年的时间。从生物学上来说，生殖衰老是一个持续的过程，但按照惯例，它被明确定义为绝经前、围绝经期和绝经后；有时通过血液样本中性激素的测量来支持这些类别。我们的目标是开发和验证一种新工具，即生殖衰老评分（RAS），它可以在不进行激素测量的情况下对生殖衰老状况进行简单而精确的描述，供卫生专业人员和研究人员使用。

方法

关于年龄、月经规律和月经频率的问卷数据由基于大型多中心人群的 RHINE 队列提供。使用模糊数学技术，根据这些变量开发了连续生殖衰老评分，以生成范围从 0.00（非绝经）到 1.00（绝经后）的小数。然后使用接受者操作特征 (ROC)，通过性激素测量（卵泡刺激素和 17β-雌二醇）和基于大型人群的 ECRHS 队列提供的访谈数据来验证 RAS。

结果

RAS 根据 RHINE 队列的问卷数据开发而成，以高精度和准确度定义了绝经状态，并由 ECRHS 队列中的访谈和激素数据证实。ROC 曲线下面积为 0.91（95% 置信区间 (CI)：0.90-0.93）来区分非绝经期女性与围绝经期和绝经后女性，0.85（95% CI：0.83-0.88）来区分绝经后女性与非绝经后女性围绝经期妇女。

结论

RAS 提供了一种有用且有效的工具，可以基于简单的问题，以 0.00 到 1.00 的连续范围准确描述生殖衰老的状态，而无需抽血。该评分可以比传统的绝经前、围绝经期和绝经后分类更精确地进行分类。这对于流行病学研究和临床试验很有用。